ZIDOVUDINE ADMINISTERED TO WOMEN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 AND TO THEIR NEONATES REDUCES PEDIATRIC INFECTION INDEPENDENT OF AN EFFECT ON LEVELS OF MATERNAL VIRUS

Objective: To determine whether zidovudine, administered to reduce ver tical transmission of human immunodeficiency virus type 1 (HIV-1), imp acts the level of maternal viral DNA within the lymphocytes of infecte d pregnant women, Study design: A prospective, nonrandomized study of 42 HIV-1 infected pregnant women, Nineteen women received zidovudine t herapy to reduce HIV-1 perinatal transmission, and 23 were untreated, HIV-1 DNA was determined by polymerase chain reaction amplification of lymphocyte DNA from maternal blood samples obtained at the time of de livery, treated and untreated, transmitting and nontransmitting groups were compared for clinical, virologic, and immunologic parameters wit h a t test or a Fisher Exact Test, and for copies of HIV-1 DNA per 10( 6) CD4(+) T cells with a Mann-Whitney rank sum test, Results: Untreate d pregnant women who transmitted HIV-1 to their infants had lower CD4( +) T-cell counts and a greater degree of immune complex dissociated p2 4 antigenemia than did the untreated nontransmitting group (p < 0.01) but did not differ significantly with respect to age, race, or mode of delivery, The level of HIV-1 proviral DNA within lymphocytes was sign ificantly greater in the untreated transmitting group than in the nont ransmitting mothers (p = 0.003). Zidovudine treatment resulted in a 78 % decrease in maternal transmission (p = 0.017), However, there was no t a significant difference in DNA copy numbers in CD4(+) T cells in th e treated compared with the untreated groups. Conclusion: Zidovudine r educes HIV-1 maternal transmission independent of its effect on the le vel of the maternal peripheral blood proviral load.